C-X3-C趋化因子配体1与新生儿中枢神经系统感染的相关性
发布时间：2018-07-29 21:17
【摘要】：目的探讨血浆或脑脊液中的C-X3-C趋化因子配体1(CX3CL1)是否可作为判断中枢神经系统感染的指标。方法以2015年12月至2016年5月复旦大学附属儿科医院新生儿病房中疑诊中枢神经系统感染行腰椎穿刺检查的新生儿为感染组,根据临床表现,脑脊液常规、生化和培养结果分为中枢感染亚组、败血症亚组和非败血症亚组。以同一时期复旦大学附属妇产科医院产科病房健康新生儿为对照组,根据出生体重分为2 000、~2 500、~3 000、~3 500和3 500 g亚组,根据孕周分为33、~35、~37、~39和39周亚组。对照组取新生儿在出生后的脐带血;感染组于急性期或稳定期行腰椎穿刺检查,24 h后取静脉血标本。采用Luminex技术检测血或脑脊液标本中的CX3CL1水平,比较各组及其亚组间的差异。结果对照组69例,感染组24例。中枢感染(化脓性脑膜炎)亚组8例,败血症亚组10例,非败血症亚组6例(脑积水2例,泌尿系统感染1例,新生儿惊厥2例、高胆红素血症伴食管气管瘘1例)。对照组脐血CX3CL1水平为(97.8±13.3)pg·mL~(-1),脐血CX3CL1水平在不同体重亚组以及不同孕周亚组间差异无统计学意义,P均0.05。CX3CL1水平在感染组血浆(95.1±8.2)pg·mL~(-1)和对照组脐血比较差异无统计学意义(P=0.299)。CX3CL1水平感染组脑脊液中(210.0±11.9)pg·mL~(-1)高于血浆,差异有统计学意义(P0.001)。感染组中的中枢感染亚组、败血症亚组和非败血症亚组脑脊液CX3CL1水平分别为(243.1±13.3)、(208.2±20.1)和(168.7±20.6)pg·mL~(-1),3组间差异有统计学意义(P=0.046);中枢感染亚组与非败血症亚组比较,差异有统计学意义(P=0.016);败血症亚组与非败血症亚组比较(P=0.180)、中枢感染亚组与败血症亚组比较(P=0.169),差异均无统计学意义。结论健康新生儿脐带血和感染新生儿外周血CX3CL1表达水平相对稳定,不适宜作为判断是否存在感染的指标,CSF中CX3CL1作为辅助诊断中枢感染和判断感染严重程度的分子标志物还需进一步扩大样本量加以证实。
[Abstract]:Objective to investigate whether C-X3-C chemokine ligand 1 (CX3CL1) in plasma or cerebrospinal fluid can be used as a marker for central nervous system infection. Methods from December 2015 to May 2016, neonates with suspected central nervous system infection in neonatal ward of affiliated paediatrics hospital of Fudan University were selected as infected group. According to their clinical manifestations, cerebrospinal fluid (CSF) routine was used. Biochemical and culture results were divided into central infection subgroup, septicemia subgroup and non-septic subgroup. The healthy newborns in obstetrical ward of the affiliated Obstetrics and Gynecology Hospital of Fudan University in the same period were taken as the control group. According to their birth weight, they were divided into 2 000 (2 000) and 3 500 g subgroups, and divided into 3 3 ~ (3 +) ~ (35) ~ (3) ~ (5) ~ (7) and 39 ~ (th) week subgroups according to the gestational age. Umbilical cord blood was collected from newborns in the control group, and venous blood samples were collected from the infected group after 24 hours of lumbar puncture examination in the acute or stable phase. Luminex technique was used to detect the level of CX3CL1 in blood or cerebrospinal fluid (CSF). Results there were 69 cases in control group and 24 cases in infection group. Central nervous system infection (suppurative meningitis) subgroup (8 cases), septicemia subgroup (10 cases), non-septicemia subgroup (6 cases) (hydrocephalus 2 cases, urinary tract infection 1 case, neonatal convulsion 2 cases, hyperbilirubinemia with esophagotracheal fistula 1 case). The CX3CL1 level of umbilical cord blood in control group was (97.8 卤13.3) PG mL ~ (-1). There was no significant difference in CX3CL1 level between different body weight subgroups and different gestational age subgroups. There was no significant difference in plasma (95.1 卤8.2) PG mL ~ (-1) between infected group and control group (P0.299). CX3CL1 level was not significantly different from that in control group (P0.299). The cerebrospinal fluid (210.0 卤11.9) PG mL ~ (-1) in infected group was higher than that in plasma. The difference was statistically significant (P0.001). The levels of cerebrospinal fluid (CX3CL1) in central infection subgroup, septicemia subgroup and non-septic subgroup were (243.1 卤13.3), (208.2 卤20.l) and (168.7 卤20.6) PG mL ~ (-1), respectively (P0.046). The difference was statistically significant (P0. 016), there was no significant difference between septicemia subgroup and non septicemia subgroup (P0. 180), central infection subgroup and septicemia subgroup (P0. 169). Conclusion the expression of CX3CL1 in umbilical cord blood and peripheral blood of infected neonates is relatively stable. It is not appropriate to use CX3CL1 as a marker for the diagnosis of central infection and to judge the severity of infection. It is necessary to further expand the sample size to confirm that CX3CL1 is a useful marker for the diagnosis of central infection and the severity of infection.
【作者单位】： 复旦大学附属儿科医院新生儿科 卫生部新生儿重点实验室;复旦大学附属妇产科医院新生儿科;中国科学院神经科学研究所;
【分类号】：R742.9
[Abstract]:Objective to investigate whether C-X3-C chemokine ligand 1 (CX3CL1) in plasma or cerebrospinal fluid can be used as a marker for central nervous system infection. Methods from December 2015 to May 2016, neonates with suspected central nervous system infection in neonatal ward of affiliated paediatrics hospital of Fudan University were selected as infected group. According to their clinical manifestations, cerebrospinal fluid (CSF) routine was used. Biochemical and culture results were divided into central infection subgroup, septicemia subgroup and non-septic subgroup. The healthy newborns in obstetrical ward of the affiliated Obstetrics and Gynecology Hospital of Fudan University in the same period were taken as the control group. According to their birth weight, they were divided into 2 000 (2 000) and 3 500 g subgroups, and divided into 3 3 ~ (3 +) ~ (35) ~ (3) ~ (5) ~ (7) and 39 ~ (th) week subgroups according to the gestational age. Umbilical cord blood was collected from newborns in the control group, and venous blood samples were collected from the infected group after 24 hours of lumbar puncture examination in the acute or stable phase. Luminex technique was used to detect the level of CX3CL1 in blood or cerebrospinal fluid (CSF). Results there were 69 cases in control group and 24 cases in infection group. Central nervous system infection (suppurative meningitis) subgroup (8 cases), septicemia subgroup (10 cases), non-septicemia subgroup (6 cases) (hydrocephalus 2 cases, urinary tract infection 1 case, neonatal convulsion 2 cases, hyperbilirubinemia with esophagotracheal fistula 1 case). The CX3CL1 level of umbilical cord blood in control group was (97.8 卤13.3) PG mL ~ (-1). There was no significant difference in CX3CL1 level between different body weight subgroups and different gestational age subgroups. There was no significant difference in plasma (95.1 卤8.2) PG mL ~ (-1) between infected group and control group (P0.299). CX3CL1 level was not significantly different from that in control group (P0.299). The cerebrospinal fluid (210.0 卤11.9) PG mL ~ (-1) in infected group was higher than that in plasma. The difference was statistically significant (P0.001). The levels of cerebrospinal fluid (CX3CL1) in central infection subgroup, septicemia subgroup and non-septic subgroup were (243.1 卤13.3), (208.2 卤20.l) and (168.7 卤20.6) PG mL ~ (-1), respectively (P0.046). The difference was statistically significant (P0. 016), there was no significant difference between septicemia subgroup and non septicemia subgroup (P0. 180), central infection subgroup and septicemia subgroup (P0. 169). Conclusion the expression of CX3CL1 in umbilical cord blood and peripheral blood of infected neonates is relatively stable. It is not appropriate to use CX3CL1 as a marker for the diagnosis of central infection and to judge the severity of infection. It is necessary to further expand the sample size to confirm that CX3CL1 is a useful marker for the diagnosis of central infection and the severity of infection.
【作者单位】： 复旦大学附属儿科医院新生儿科 卫生部新生儿重点实验室;复旦大学附属妇产科医院新生儿科;中国科学院神经科学研究所;
【分类号】：R742.9
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